Outcomes of Primary Reverse Shoulder Arthroplasty for Dislocation Arthropathy

Abstract

Background Proper soft tissue balance is paramount to maintaining stability and a functional arc of motion in shoulder arthroplasty but is impaired in patients with prior glenohumeral (GH) dislocations. The purpose of this study was to determine the clinical outcomes, revisions, and complications of reverse shoulder arthroplasty (RSA) in patients with a history of glenohumeral dislocation. Methods Twenty-four patients with a history of GH dislocations that developed arthropathy underwent primary RSA from 2007 to 2013 were retrospectively reviewed. Mean follow-up was 3.3 years (2–7 years). Mean age was 70 years. Eight patients (33%) and 7 patients (29%) had complete or partial subscapularis deficiency, respectively. Results Twenty-two patients (92%) had little to no pain at final follow-up. Mean shoulder elevation improved from 48° to 120° ( P < .001) and mean external rotation increased from 13.2° to 48° ( P < .001). There were trends toward less complete pain relief and poorer motion in those with complete subscapularis deficiency. None of the patients experienced a postoperative dislocation or evidence of glenoid loosening at final radiographic follow-up, but 1 patient (4.2%) underwent early revision to a hemiarthroplasty for glenoid loosening. Conclusion RSA provides patients with prior glenohumeral dislocations a stable, pain-free arc of motion. Postoperative instability was not identified as a major failure mode at short-term follow-up. Complete subscapularis deficiency is a risk factor for poorer clinical outcome.